Pediatric liver transplant recipients often undervaccinated

Many pediatric liver transplant recipients are undervaccinated, according to a research letter published in the Nov. 12 issue of the Journal of the American Medical Association.

Amy G. Feldman, M.D., from the University of Colorado Denver, and colleagues examined the percentage of patients at Society of Pediatric Liver Transplantation centers who were up to date for their age on immunizations at the time of transplant. Data were obtained for all patients younger than 18 years who underwent a liver transplant between August 2017 and August 2018. Up-to-date vaccination status was determined using three vaccine schedules: the National Immunization Survey (NIS), the U.S. Centers for Disease Control and Prevention immunization schedule for healthy children, and the 2013 Infectious Diseases Society of America (IDSA) Clinical Practice Guideline for Vaccination of the Immunocompromised Host. Immunization records were available for 281 patients.

The researchers found that 55, 29, and 19 percent of the patients were up to date on immunizations based on the NIS requirements, CDC schedule, and IDSA accelerated schedule, respectively. Based on the CDC schedule, the percentage of children up to date for individual vaccines varied from 50 to 94 percent for Haemophilus influenzae type b and meningococcus, respectively. No demographic or clinical factors were significantly associated with undervaccination.

"Particularly concerning was underutilization of live vaccines in young children, which are not routinely recommended after transplant," the authors write.

One author disclosed receiving funding from Sanofi-Pasteur for a different study.

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